Aging Matters Through the Years: A Retrospective.

The goal of the Aging Matters column is to address important issues related to geropsychiatry and the well-being of older adults. This article offers reflections on columns from the past 15 years and how the aging process has changed in issues related to aging and technology, aging healthfully, end-of-life issues, caregivers for older adults, and growing old in American society. To promote successful aging, we need to hear stories of what it is like to grow old in America. We also need research to better understand the aging process and what is needed for successful aging. In addition, we need policies and resources that help ensure well-trained caregivers who can protect vulnerable older adults and help them age healthfully. Stories of individuals, research, and health care policies need to be connected to create meaningful changes within the health care system. [Journal of Psychosocial Nursing and Mental Health Services, 59(10), 7-11.].

The Aging Brain: Can Cognitive Decline Be Reversed?

Little research has focused on aging changes in the normal brain, despite its significance as a public health problem. Recent research on neural mechanisms that underlie cognitive decline in the aging brain suggests that neuro-genesis, the creation of new brain cells, is possible throughout one's life. Research findings offer nurses and other health professionals new opportunities to encourage behavior changes for older adults that may eventually slow or reverse detrimental changes in the aging brain. [Journal of Psychosocial Nursing and Mental Health Services, 59(7), 13-16.].

Losing a Generation: The Impact of COVID-19 on Older Americans.

As COVID-19 is killing untold numbers of older adults around the world, it is important to reflect on the loss of this generation. Approximately eight in 10 deaths were in people aged ≥65 years. This is a devastating loss to our society-losses that will last long after the pandemic has run its course. Lock-downs and visitor restrictions that were meant to protect older adults created an isolation that often led to declining health. Ageist stereotypes, prejudice, and discrimination are internalized by older adults as they face being devalued and viewed as a burden. Reflecting on what has been lost with the deaths of so many from this older generation can spur us to think about how society failed to protect them and to find ways to move beyond the stigma attached to being old. We have much to learn from this generation. [Journal of Psychosocial Nursing and Mental Health Services, 59(4), 9-12.].

Tidying Up: Good for the Aging Brain.

As older adults experience physical and mental changes, they may have difficulty keeping up with tasks that were once routine and may be faced with a growing accumulation of once important possessions that are no longer needed. Problems with clutter have been associated with stress and life dissatisfaction. Helping older adults realize the benefits of decluttering their living environment and providing them with advice on how to do this can help them feel accomplished and in control. [Journal of Psychosocial Nursing and Mental Health Services, 58(4), 16-18.].

Suicide in Older Adults.

Suicide in older adults is a critical problem that nurses and other health professionals need to address. Evidence-based interventions for prevention of late-life suicide are urgently needed, as well as increased availability of health care professionals with knowledge and skills to recognize suicide risks and intervene to provide effective care for this vulnerable population. [Journal of Psychosocial Nursing and Mental Health Services, 58(1), 17-20.].

Music as a Healing Art in Dementia Care.

Music is an easily accessible and stimulating medium that can be enjoyed alone or with others, even in the context of severe dementia. The power of music to improve the lives of individuals with dementia, as well as their caregivers, is becoming increasingly recognized as more research is focused on underlying neural relationships and evidence-based music interventions. Nurses and other health professionals can be instrumental in designing and implementing music-based interventions and expanding needed research to promote music as a healing art in dementia care. [Journal of Psychosocial Nursing and Mental Health Services, 56(7), 15-18.].

End-of-Life Conversations as a Legacy.

Advance directives such as living wills and health care powers of attorney are important documents that offer patients ways to avoid unwanted care when they are unable to express their wishes. Although health care professionals have increased focus on advance care planning in recent years, approximately two thirds of American adults do not have advance medical directives. In addition, 90% of individuals believe that talking to loved ones about end-of-life wishes is important, but only 27% have done so. It is important for nurses to understand the complex factors that influence how individuals make health care decisions and identify ways to encourage conversations with family, friends, and health care providers to help clarify patients' wishes for endof-life care. [Journal of Psychosocial Nursing and Mental Health Services, 56(1), 32-35.].

Promoting Human Flourishing in Aging.

Human flourishing represents a state of mental health in which an individual is actively striving to live well rather than merely feeling good. This concept provides an important context for nurses working with older adults. Flourishing older adults exhibit a sense of personal growth in that they are still evolving and changing. Research suggests that human flourishing is associated with positive outcomes for mental and physical health. Thus, it is important for nurses and other health professionals to help older adults identify and implement strategies that promote flourishing in their later years. [Journal of Psychosocial Nursing and Mental Health Services, 55(10), 27-30.].

Living with Parkinson's Disease: Staying Determined.

Parkinson's disease is one of the most common chronically disabling disorders of the nervous system. The disorder affects predominately older adults; only 4% of individuals are diagnosed before age 50. Receiving a diagnosis of Parkinson's disease can be overwhelming for someone who is active and feels healthy, but new research shows that patients who take charge of their illness by adopting healthful habits of mind and body can slow the development of the disease and have a better quality of life. [Journal of Psychosocial Nursing and Mental Health Services, 55(4), 15-18.].

Substance Use Disorders in Long-Term Care Settings: A Crisis of Care for Older Adults.

Many older adults struggle with lifelong addictions or become addicted to prescription drugs that they take for coping with physical or psychological pain. There has been little attention, however, focused on this problem in nursing homes, where powerful pain medications are administered routinely. The nursing home setting provides complex challenges for staff and administrators attempting to provide safe and high-quality care for older adults with substance use disorders. Nurses working in long-term care settings, hospitals, and the community need to be sensitive to the possibility of older adults being addicted to alcohol or drugs and identify strategies for addressing this problem. [Journal of Psychosocial Nursing and Mental Health Services, 55(1), 24-27.].

Community-Based Older Adults With Mental Illness: We Can Do Better.

One third of older adults in the community have significant mental health problems, but many do not receive needed treatment for problems such as depression, anxiety, and psychotic disorders. Without effective community-based mental health services, older adults may give up and withdraw from treatment. New collaborative and integrative models of mental health services are being implemented that offer innovative roles for nurses. It is important that nurses, as well as other health care professionals, researchers, and policy makers, continue to advocate for a mental health care system that is accessible and effective for older adults in the community. [Journal of Psychosocial Nursing and Mental Health Services, 54 (11), 25-29.].

Aging on the Street: Homeless Older Adults in America.

Older adults are at greater risk for homelessness today than at any time in recent history. Approximately one half of homeless individuals in America are older than 50, which has created serious challenges for how cities, governments, and health care providers care for homeless populations. Systems established in the 1980s to help care for homeless individuals were not designed to address problems of aging. It is critical that nurses and all health professionals have a better understanding of the unique needs and concerns of homeless older adults. Nurses can be an important part of the solution, not only through direct patient care but by advocating for improvements in care for this vulnerable population. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 25-29.].

Meditation for older adults: a new look at an ancient intervention for mental health.

New research is providing health care professionals with evidence for the effectiveness of mindfulness meditation as an intervention for older adults. Recent studies have provided evidence that meditation results in observable changes in brain structure related to memory, sense of self, empathy, and stress. Health care professionals should consider mindfulness training as a helpful intervention for older adults with problems such as depression, anxiety, chronic pain, loneliness, and caregiver burden.

Enhancing care of older adults in the emergency department: old problems and new solutions.

The dramatic increase in the number of older adults in our society is creating greater demand for age-appropriate health care services. Because older adults use proportionally more emergency services than any other age group, it is important to address problems and find solutions to emergency care for this vulnerable population. Older adults often need specialized care to meet complex physical and psychological needs in an emergency department (ED). A new focus on establishing geriatric EDs holds promise for reducing barriers to ED access and decreasing suboptimal outcomes. Recently published geriatric ED guidelines provide health care professionals with recommendations to systematically improve emergency care for older adults.

Nurses Managing Patients' Pain May Experience Moral Distress.

Bedside nurses care for patients with pain every day but the task is often challenging. A previous qualitative study that investigated nurses' experiences as they treated patients with pain suggested that nurses may suffer from moral distress if they are unsuccessful in providing adequate pain relief. As 20 of the original 48 nurses interviewed described frustration and distress when constrained from doing the right thing to provide pain relief for their patients, the purpose of this secondary qualitative analysis was to answer new research questions on nurse moral distress related to managing pain. Findings indicated that difficulties in nurse/physician communication and lack of pain education were contributors to nurses' frustrations and provided barriers to optimal pain management. Many participants indicated a need for interprofessional pain management education. Further investigation is needed to clarify the impact of moral distress on nurses managing hospitalized patients' pain.

Postoperative cognitive dysfunction in older adults: a call for nursing involvement.

As the population continues to age and new medical developments make surgery at advanced ages increasingly possible, it is important to consider how older adults tolerate surgery and anesthesia. Considerable evidence shows that older adults have a higher risk of developing postoperative cognitive dysfunction (POCD), which leads to transient and sometimes long-term cognitive changes that may affect quality of life. Because little is known about how to prevent or treat POCD, it is important that nurses identify ways in which they can intervene to help patients who experience this disorder.

Use of technology to enhance mental health for older adults.

Recent research suggests that older adults may gain significant mental health benefits from health resources made available through emerging modern technologies, especially because this population is becoming more Internet savvy. Technology-enhanced interventions for older adults have been shown to be helpful not only for general wellness activities (i.e., exercise), but also to specifically enhance mental health. This article focuses on two types of interventions for mental health: (a) cognitive-behavioral therapy for depression and anxiety and (b) assistive technology for individuals with dementia. Nurses should reevaluate their assumptions that older adults fear technology and explore whether different types of modern technology might be effective in enhancing mental health for these clients.

Deciding for others: surrogates struggling with health care decisions.

As the number of older adults in our society increases, surrogate decision makers are increasingly likely to be called on to make complex, and often agonizing, health care decisions for loved ones. Recent studies of surrogate decision making have described the decision-making process as overwhelming and stressful. Nurses play an important role in helping family members to make meaningful decisions with less stress. Nurses who serve as educators, advocates, and compassionate listeners can help reduce the deleterious effects of surrogates' difficult decisions. It is important that nurses and other health care professionals find effective ways to support surrogates who struggle with making decisions for others.

Moving beyond caregiver burden: identifying helpful interventions for family caregivers.

Family members serving as informal caregivers for loved ones often experience physical, psychological, emotional, social, and financial consequences that can be conceptualized as caregiver burden. As the number of older adults in our society continues to increase, there will be even more demand for family caregivers. It is important to move beyond a focus on the statistics and characteristics of caregiver burden and identify helpful interventions to reduce this burden. Interventions that decrease caregiver burden can enable family caregivers to delay placement of the individual in an institutional setting and improve quality of life for both the caregiver and care recipient.

Dialog on a country path: the qualitative research journey.

There is little information in the literature describing how students learn qualitative research. This article describes an approach to learning that is based on the pedagogical approach of Dinkins' Socratic-Hermeneutic Shared Inquiry. This approach integrates shared dialog as an essential aspect of learning. The qualitative pedagogy described in this article focused on three questions: What is knowing in qualitative research? How do we come to know qualitative research? What can we do with qualitative research? Students learned the basics of qualitative research within a context that fostered interpretive inquiry. In this way, the course framework mirrored the combination of interviewing, storytelling, and journeying toward understanding that constitute qualitative research.